PMID- 10200860
OWN - NLM
STAT- MEDLINE
DCOM- 19990602
LR  - 20170214
IS  - 1060-0280 (Print)
IS  - 1060-0280 (Linking)
VI  - 33
IP  - 3
DP  - 1999 Mar
TI  - Epoprostenol in primary pulmonary hypertension.
PG  - 340-7
AB  - OBJECTIVE: To review briefly the epidemiology, pathophysiology, and current 
      treatment of primary pulmonary hypertension (PPH) and review the available 
      clinical data on epoprostenol in PPH. DATA SOURCES: A MEDLINE search (January 
      1966-August 1998) was used to identify case reports and clinical studies 
      pertaining to epoprostenol in PPH. Bibliographic lists were also used. STUDY 
      SELECTION: All English-language clinical studies of epoprostenol in PPH were 
      included. Incomplete study descriptions (abstracts) were not included. DATA 
      EXTRACTION: Study design, population, methods, clinical outcomes, and adverse 
      effects were evaluated. DATA SYNTHESIS: PPH is a relatively rare disease that 
      results in symptoms of congestive heart failure and has a five-year survival rate 
      of 34%. Therapy has consisted of vasodilators, anticoagulation, oxygen, and 
      ultimately lung transplantation. Epoprostenol, which has recently become 
      available as an integral pharmacotherapeutic option, has been shown to improve 
      hemodynamic parameters such as cardiac output, pulmonary artery pressure, and 
      pulmonary vascular resistance. It has been shown to improve exercise parameters, 
      New York Heart Association (NYHA) functional class, and survival. Epoprostenol is 
      indicated for patients with severe disease (NYHA class III or IV) who do not 
      respond to acute vasodilator challenge or chronic calcium-channel blocker 
      therapy. Its chronic administration is challenging as it requires continuous 
      infusion via central venous catheter and a special infusion pump. Administration 
      is further complicated by the 48-hour expiration of reconstituted epoprostenol 
      and the need to refrigerate the reconstituted drug. CONCLUSIONS: Epoprostenol 
      improves hemodynamics and clinical outcome in patients with severe PPH. 
      Epoprostenol therapy requires intensive patient education and medical monitoring, 
      but it can improve well-being and delay the need for lung transplantation.
FAU - Herner, S J
AU  - Herner SJ
AD  - School of Pharmacy, University of Wyoming, Laramie, USA.
FAU - Mauro, L S
AU  - Mauro LS
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Antihypertensive Agents)
RN  - DCR9Z582X0 (Epoprostenol)
SB  - IM
MH  - Antihypertensive Agents/*therapeutic use
MH  - Epoprostenol/*therapeutic use
MH  - Humans
MH  - Hypertension, Pulmonary/*drug therapy/epidemiology/physiopathology
RF  - 23
EDAT- 1999/04/14 00:00
MHDA- 1999/04/14 00:01
CRDT- 1999/04/14 00:00
PHST- 1999/04/14 00:00 [pubmed]
PHST- 1999/04/14 00:01 [medline]
PHST- 1999/04/14 00:00 [entrez]
AID - 10.1345/aph.17339 [doi]
PST - ppublish
SO  - Ann Pharmacother. 1999 Mar;33(3):340-7. doi: 10.1345/aph.17339.